Provider Demographics
NPI:1417843798
Name:BONILLA, FLORDELIZA
Entity type:Individual
Prefix:
First Name:FLORDELIZA
Middle Name:
Last Name:BONILLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 KALIHI ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-3612
Mailing Address - Country:US
Mailing Address - Phone:808-364-6357
Mailing Address - Fax:808-845-2308
Practice Address - Street 1:2211 KALIHI ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-3612
Practice Address - Country:US
Practice Address - Phone:808-364-6357
Practice Address - Fax:808-845-2308
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-14
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1-240085253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care